Healthcare Provider Details

I. General information

NPI: 1780256891
Provider Name (Legal Business Name): TURNER HOUSE CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 N 12TH ST STE 201
KANSAS CITY KS
66102-5172
US

IV. Provider business mailing address

21 N 12TH ST STE 300
KANSAS CITY KS
66102-5105
US

V. Phone/Fax

Practice location:
  • Phone: 913-342-2552
  • Fax: 913-342-3220
Mailing address:
  • Phone: 913-342-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: PATRICK SALLEE
Title or Position: CEO
Credential:
Phone: 913-320-2607